Dr. James Holsinger's nomination to be surgeon general colored by questionable deaths at a VA hospital where he was Chief Medical Officer, along with his record of homophobia and involvement in a questionable Kentucky land deal

While the George W. Bush administration didn't invent cronyism -- handing over administration jobs to friends, funders and longtime supporters -- it certainly has put its own unique stamp on the concept. When the history of the Bush Administration is written, "cronyism" will be writ large with Bush's paean to former FEMA chief Michael Brown, "Brownie, you're doing a heck of a job," leading the way. The hiring -- and ultimate firing -- of "Brownie," however, is only one example of how the uninformed, the unprepared, the prejudiced, and the unqualified have made their way to administration posts.

And that's just about where President Bush's nomination of Dr. James Holsinger to be surgeon general comes in.

Most of the early stories about Holsinger have talked about his controversial history of anti-gay remarks, decisions and communications, particularly through his work with the United Methodist Church. A deeper look, however, reveals a controversial tenure as chief medical officer for the Department of Veterans Affairs and a Kentucky real estate deal gone sour.

Here is how White House spokesperson Emily Lawrimore described him: "Dr. Holsinger has dedicated his life to the care of others and public service and his respect for all is evidenced by his actions and his career. On numerous occasions, he has taken up the banner for under represented populations and he will continue to be a strong advocate for these groups and all Americans. Dr. Holsinger is a highly respected, well-qualified physician and educator. His impressive medical background, which includes leading one of the Nation's largest healthcare systems, decades of service in the armed forces, along with his commitment to combating childhood obesity, will serve him well as Surgeon General. We urge the Senate for a swift confirmation."

When the Bush Book of Cronies is written, will Holsinger receive a full chapter or merely a passing mention?

Holsinger and homosexuality

Cynthia B. Astle of the United Methodist Nexus points out that Holsinger "rose to national prominence" in the United Methodist Church "through his membership on the 1989-92 churchwide Committee to Study Homosexuality." Astle notes that Holsinger "resigned from the committee shortly before the 1992 General Conference in Louisville, KY, because he said the committee's report was 'skewed toward liberal interpretations' of homosexual orientation and behavior. At the time, Holsinger declined the committee's invitation to be included in a minority report on the subject."

According to reporter Max Blumenthal, in a 1991 paper written by Holsinger titled "The Pathophysiology of Male Homosexuality" he "describes homosexual sex in sickeningly lurid language. 'Fist fornication,' 'sphincter injuries,' 'lacerations,' 'perforations' and 'deaths seen in connection with anal eroticism,' are some of the terms Holsinger concocted to describe acts with which he suggests at least medical familiarity ..."

During the course of a recent editorial calling Holsinger an "outstanding choice," the Louisville Courier-Journal pointed out that his "paper on gay sex is ... problematic. In addition to being needlessly cruel, his remarks ran against mainstream medical and psychological thought -- that sexual orientation is an innate (and, thus, in a sense 'natural') quality."

Holly Babin, a spokeswoman for the Department of Heath and Human Services -- the agency that evidently will take the lead on trying to get Holsinger confirmed -- put her spin on the paper: "That paper was a survey of scientific peer-reviewed studies that he was asked to compile by the United Methodist Church, it's not that he was saying 'this is what I believe,'" Babin said. "It's a reflection of the available scientific data from the 1980s. It should be noted that in 1991, homosexuals were banned from the military and several years before that, homosexuality and Haitian nationality were considered risk factors for HIV/AIDS. Over the last 20 years, a clearer understanding of these issues has been achieved."

But as Astle points out, this wasn't an isolated incident:

... Holsinger has consistently supported forces in the denomination opposed to the acceptance of gay, lesbian, bisexual and transgender people. He has served previously on the board of the Indianapolis-based Confessing Movement within The United Methodist Church, a 15-year-old unofficial organization dedicated to "preserving the apostolic faith", according to a statement on its web site. Current Confessing Movement board members include Asbury Seminary chancellor Dr. Maxie Dunnam and layman David W. Stanley, also a director of the Institute on Religion and Democracy.

... . During Holsinger's term on the Judicial Council, the church's "supreme court" has ruled consistently against acceptance of homosexual people. In 2005, the council upheld the defrocking of Rev. Beth Stroud, a lesbian, affirming the church's prohibition against ordaining GLBT people. Also that year, the Judicial Council set off a wave of debate in the church by siding with a Virginia pastor who refused membership to an openly gay man in Decision 1032. Several annual conferences this year have adopted resolutions challenging the views expressed in Decision 1032.

Holsinger tries to pocket the money from hospital sale

According to the blog Assembled Reflections, Holsinger, who is president of the United Methodist Church's Judicial Council, also serves as chairman of the Good Samaritan Foundation, "a philanthropic organization dedicated to serving the health care needs of Kentucky's poor and disadvantaged," which claims on its website to have "no political, religious, institutional, or other affiliations."

Assembled Reflections has a different take:

The Good Samaritan Hospital has a historic link to the Kentucky Conference of the United Methodist Church, and until Dr. Holsinger's tenure as chairman the Foundation reported to the Kentucky Annual Conference. When the hospital was sold, the Foundation's board placed the money--around $20 million--into a fund it controls. Now Dr. Holsinger maintains that the Foundation is an independent entity with no ties to Kentucky United Methodism. Fayette Circuit Judge Gary Payne disagreed, ruling that the hospital belonged to the Church and so does the fund.

The Good Samaritan Foundation, under Dr. Holsinger's leadership, has appealed ... . [and] has chosen to take the argument to the public square and portray the Church negatively. Dr. Holsinger is quoted as saying the Church is "only interested in the Foundation's money, not its cause." Note the wording here--"the Foundation's money." The Conference owns a hospital, that hospital is sold, yet the proceeds generated belong to the Foundation and not to the Conference? The fact that Holsinger's cause is worthy does not make the money his.

Déjà vu all over again

On November 22, 1991, the New York Times reported that congressional investigator Mary Ann Curran testified before a House subcommittee "that she found shoddy care at veterans hospitals, including several cases in which incompetence and neglect led to the deaths of patients." Curran, a health-care investigator for the General Accounting Office, told the House Government Operations Subcommittee on Human Resources and Intergovernmental Relations that "We discovered several cases of patients who had died because of errors made by unsupervised interns or residents."

Curran visited six hospitals and studied the records of another 30 facilities in her investigation.

Holsinger, chief medical director of the department, testifying before the same committee, admitted that the VA was "obviously not perfect." He said: "Our system is obviously not perfect; no health care system is. Our patients are older, sicker and more complex than the average patient."

At a briefing prior to the hearing, Holsinger denied that there were systemic problems in the VA medical system.

"However, three months later," Cynthia Astle noted, "the government ruled that the unit Holsinger directed was responsible for six of 15 documented deaths at a North Chicago veterans' hospital. Veterans' Affairs subsequently negotiated confidential settlements with the patients' families."

Up from Kansas

Born in Kansas City, Kansas, Holsinger has a Ph.D. in anatomy and a medical degree from Duke University, along with a master's degree in hospital management from the University of South Carolina. He also has a master's degree in biblical studies from multidenominational Asbury Theological Seminary in Wilmore, Kentury.

According to Astle, while Holsinger was "trained in general surgery and cardiology, and [was] described in President Bush's announcement as a cardiologist, [he] has no national board certification in any speciality, according to the web site of the American Board of Medical Specialities:

Holsinger currently holds the Wethington Chair in Health Sciences and serves as professor of preventive medicine at the University of Kentucky College of Public Health. Prior to his current UK post, Holsinger led the Commonwealth of Kentucky Cabinet for Health and Family Services from 2003 to 2005. Before that, he was chancellor of UK's A.B. Chandler Medical Center for nine years, and directed the Veterans Affairs Medical Center in Lexington, KY, from 1993 to 1994. Altogether, Holsinger served with the Veterans Administration, renamed the Department of Veterans Affairs in 1989, from 1969 through 1994. He rose to chief medical director and undersecretary of health for the agency under President George H.W. Bush. Holsinger retired from the Army Reserve Medical Corps in 1993 with the rank of major general.

Newsmeat.com reports that Holsinger has contributed more than $17,000 to Republican Party candidates and causes.

Thus far, a date has not yet been set for Holsinger's confirmation hearing before the Senate Committee on Health, Education, Labor and Pensions, chaired by Sen. Ted Kennedy (D-MA). If confirmed, Holsinger would succeed Richard H. Carmona, who resigned at the end of his term in July 2006.

It will be up to that committee to determine whether Holsinger moves on to the full Senate for a vote.